Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-24T10:06:17.998Z Has data issue: false hasContentIssue false
  • English
  • Français

Surveillance for Hospital-Acquired Infections on Surgical Wards in a Dutch University Hospital

Published online by Cambridge University Press:  02 January 2015

Titia E. M. Kamp-Hopmans ,
Hetty E. M. Blok ,
Annet Troelstra ,
Ada C. M. Gigengack-Baars ,
Annemarie J. L. Weersink ,
Christina M. J. E. Vandenbroucke-Grauls ,
Jan Verhoef  and
Ellen M. Mascini
Titia E. M. Kamp-Hopmans*
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
Hetty E. M. Blok
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
Annet Troelstra
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
Ada C. M. Gigengack-Baars
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
Annemarie J. L. Weersink
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
Christina M. J. E. Vandenbroucke-Grauls
Affiliation:
Universiteit Medical Center Amsterdam, Department of Medical Microbiology and Infection Control, Amsterdam, the Netherlands
Jan Verhoef
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
Ellen M. Mascini
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, Utrecht, the Netherlands
*
University Medical Center Utrecht, Department of Infection Control, HP G04.614, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections.

Methods:

Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and vascular, thoracic, orthopedic, and general gynecologic and gynecologic-oncologic surgery of the University Medical Center Utrecht, the Netherlands. Data were collected from patients with and without infections, using criteria of the Centers for Disease Control and Prevention.

Results:

The infection control team recorded 648 hospital-acquired infections affecting 550 (14%) of 3,845 patients. The incidence density was 17.8 per 1,000 patient-days. Patients with hospital-acquired infections were hospitalized for 19.8 days versus 7.7 days for patients without hospital-acquired infections.

Prolongation of stay among patients with hospital-acquired infections may have resulted in 664 fewer admissions due to unavailable beds. Different specialties were associated with different infection rates at different sites, requiring a tailor-made approach. Interventions were recommended for respiratory tract infections in the thoracic surgery ward and for surgical-site infections in the orthopedic and gynecologic surgery wards.

Conclusions:

Surveillance in four surgical wards showed that each had its own prominent infection, risk factors, and indications for specific recommendations. Because prospective surveillance requires extensive resources, we considered a modified approach based on a half-yearly point-prevalence survey of hospital-acquired infections in all wards of our hospital. Such surveillance can be extended with procedure-specific prospective surveillance when indicated.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 8 , August 2003 , pp. 584 - 590
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Haley, RW, Culver, DH, White, JW, et al.The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
2.The Health Council of the Netherlands. Prevention and Control of Nosocomial Infections. Rijswijk, the Netherlands: The Health Council of the Netherlands; 1990.Google Scholar
3.Quality of Health Care Institutions. Gravenhage, the Netherlands: SDU; 1994.Google Scholar
4.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128–140.Google Scholar
5.Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.Google Scholar
6.Vandenbroucke, JP, Hofman, A. Basics of Epidemiology, 4th ed. [in Dutch]. Utrecht, the Netherlands: Bunge; 1993.Google Scholar
7.Dutch Working Party on Infection Prevention. Guideline for General Precautions (Guideline Number 1). Leiden, the Netherlands: Dutch Working Party on Infection Prevention; 1999.Google Scholar
8.Gigengack-Baars, ACM, Kamp-Hopmans, TEM, Troelstra, A, Mascini, EM, Blok, HEM. Handbook of Hygiene and Sterilization. Utrecht, the Netherlands: Department of Infection Control, University Medical Center Utrecht; 2002.Google Scholar
9.Haley, RW. The scientific basis for using surveillance and risk factor data to reduce nosocomial infection rates. J Hosp Infect 1995;30:3–14.Google Scholar
10.Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725–730.Google Scholar
11.Geubbels, ELPE, Mintjes-de Groot, AJ, van den Berg, JMJ, de Boer, AS. An operating surveillance system of surgical site infections in the Netherlands: results of the PREZIES national surveillance network. Infect Control Hosp Epidemiol 2000;21:311–318.Google Scholar
12.Haley, RW. Measuring the costs of nosocomial infections: methods for estimating economic burden on the hospital. Am J Med 1991;91(suppl 1):32–38.Google Scholar
13.Kluijtmans, JAJW, Mouton, JW, Maat, ARWM, Manders, MAAJ, Michel, MF, Wagenvoort, JHT. Surveillance of postoperative infections in thoracic surgery. J Hosp Infect 1994;27:139–147.Google Scholar
14.Carrel, T, Schmid, ER, von Segesser, L, Vogt, M, Turma, M. Preoperative assessment of the likelihood of infection of the lower respiratory tract after cardiac surgery. Thorac Cardiovasc Surg 1991;39:85–88.Google Scholar
15.Ephgrave, KS, Kleiman-Wexler, R, Pfaller, M, Booth, B, Werkmeister, L, Young, S. Postoperative pneumonia: a prospective study of risk factors and morbidity. Surgery 1993;114:815–821.Google Scholar
16.Lizán-Garcia, M, Garcia-Caballero, J, Asensio-Vegas, A. Risk factors for surgical-wound infection in general surgery: a prospective study. Infect Control Hosp Epidemiol 1997;18:310–315.Google Scholar
17.Whitehouse, JD, Friedman, ND, Kirkland, KB, Richardson, WJ, Sexton, DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 2002;23:183–189.Google Scholar
18.Geubels, ELPE, van Dieten, HEM, Mintjes-de Groot, AL, van den Berg, JMJ, de Boer, AS. PREZIES: prevention of nosocomial infections through surveillance: Part II. Surgical site infections [in Dutch]. Bilthoven, the Netherlands: RIVM/CBO; 1999.Google Scholar
19.Platt, R. Progress in surgical-site infection surveillance. Infect Control Hosp Epidemiol 2002;23:361–363.Google Scholar